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- Title
Allogeneic blood stem cell transplantation in advanced hematologic cancers.
- Authors
Przepiorka, D; Anderlini, P; Ippoliti, C; Khouri, I; Fietz, T; Thall, P; Mehra, R; Giralt, S; Gajewski, J; Deisseroth, A B; Cleary, K; Champlin, R; van Besien, K; Andersson, B; Körbling, M
- Abstract
Allogeneic bone marrow transplantation for advanced hematologic cancer is associated with a high risk of early treatment-related morbidity and mortality. To determine the short-term benefits of allogeneic blood stem cell transplants when compared to bone marrow transplants, we reviewed outcomes of 74 adults with advanced hematologic cancer transplanted from HLA-matched related donors after conditioning with thiotepa, busulfan and cyclophosphamide. There were three cohorts: group 1 received bone marrow transplants with cyclosporine (CsA) and methotrexate (MTX) for GVHD prophylaxis; group 2 received bone marrow transplants with CsA and methylprednisolone (MP); and group 3 received blood stem cells with CsA and MP. All patients received filgrastim post-transplant. Median times (range) to neutrophils 0.5 × 109/l were 17 (8–30), 9 (8–16) and 10 (8–13) days post-transplant, and to platelets 20 × 109/l were 28 (14–100+), 19 (13–100+) and 14 (9–86) days post-transplant for groups 1, 2 and 3, respectively (P < 0.05 only for group 1 vs group 3 for both outcomes). Blood stem cell recipients had the least regimen-related toxicity, fewest early deaths and earliest discharge. There was no significant difference in acute GVHD between the three groups. One hundred and eighty-day survivals (95% CI) were 53% (35–72%), 32% (10–53%), and 68% (49–87%) for groups 1, 2 and 3, respectively (P < 0.05 only for group 2 vs group 3). For allogeneic transplantation, use of blood stem cell grafts has substantial advantages over marrow grafts.
- Subjects
HOMOGRAFTS; STEM cell transplantation; LEUKEMIA
- Publication
Bone Marrow Transplantation, 1997, Vol 19, Issue 5, p455
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/sj.bmt.1700692